Child Health Research Centre, The University of Queensland Faculty of Medicine and Biomedical Sciences, Brisbane, Queensland, Australia
Department of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA.
BMJ Open. 2022 Aug 16;12(8):e059300. doi: 10.1136/bmjopen-2021-059300.
This study sought to evaluate the prevalence, timing of onset and duration of symptoms of depression in the perinatal period (PND) in women with depression, according to whether they had a history of depression prior to their first perinatal period. We further sought to identify biopsychosocial correlates of perinatal symptoms in women with depression.
The Australian Genetics of Depression Study is an online case cohort study of the aetiology of depression. For a range of variables, women with depression who report significant perinatal depressive symptoms were compared with women with lifetime depression who did not experience perinatal symptoms.
In a large sample of parous women with major depressive disorder (n=7182), we identified two subgroups of PND cases with and without prior depression history (n=2261; n=878, respectively).
The primary outcome measure was a positive screen for PND on the lifetime version of the Edinburgh Postnatal Depression Scale. Descriptive measures reported lifetime prevalence, timing of onset and duration of PND symptoms. There were no secondary outcome measures.
The prevalence of PND among parous women was 70%. The majority of women reported at least one perinatal episode with symptoms both antenatally and postnatally. Of women who experienced depression prior to first pregnancy, PND cases were significantly more likely to report more episodes of depression (OR=1.15 per additional depression episode, 95% CI 1.13 to 1.17, p<0.001), non-European ancestry (OR 1.5, 95% CI 1.0 to 2.1, p=0.03), severe nausea during pregnancy (OR 1.3, 95% CI 1.1 to 1.6, p=0.006) and emotional abuse (OR 1.4, 95% CI 1.1 to 1.7, p=0.005).
The majority of parous women with lifetime depression in this study experienced PND, associated with more complex, severe depression. Results highlight the importance of perinatal assessments of depressive symptoms, particularly for women with a history of depression or childhood adverse experiences.
本研究旨在评估首次产前期间（PND）患有抑郁症的女性中，根据其是否有产前抑郁史，评估围产期抑郁症状的患病率、发病时间和持续时间。我们还试图确定围产期抑郁症状与患有抑郁症的女性的生物心理社会因素的相关性。
澳大利亚抑郁症遗传学研究是一项针对抑郁症病因的在线病例队列研究。对于一系列变量，我们将报告有显著围产期抑郁症状的患有抑郁症的女性与有终身抑郁但没有经历围产期症状的女性进行了比较。
在一个有大量产后患有重度抑郁症的女性（n=7182）的样本中，我们确定了两组 PND 病例，一组有产前抑郁史（n=2261），另一组无产前抑郁史（n=878）。
主要结果测量是在爱丁堡产后抑郁量表的终身版本上进行阳性筛查。描述性测量报告了围产期症状的终身患病率、发病时间和持续时间。没有次要结果测量。
有产褥期的女性中，PND 的患病率为 70%。大多数女性报告至少有一次围产期发作，既有产前也有产后。在首次怀孕前患有抑郁症的女性中，PND 病例更有可能报告更多次的抑郁症发作（OR=1.15，每增加一次抑郁发作，95%CI 1.13 至 1.17，p<0.001）、非欧洲血统（OR 1.5，95%CI 1.0 至 2.1，p=0.03）、怀孕时严重恶心（OR 1.3，95%CI 1.1 至 1.6，p=0.006）和情感虐待（OR 1.4，95%CI 1.1 至 1.7，p=0.005）。
在这项研究中，大多数有终身抑郁症的产后女性经历了 PND，与更复杂、更严重的抑郁症有关。结果强调了对围产期抑郁症状进行评估的重要性，尤其是对有抑郁症或儿童期不良经历史的女性。
